Thirty years of the Journal Ciência & Saúde Coletiva and Workers’ Health: characteristics and contemporary challenges

Abstract

Ciência & Saúde Coletiva Journal (C&SC) has become a recognized reference in the dissemination of scientific knowledge in the field of Health and Work. As part of the journal’s 30^th anniversary, this article presents a critical reflection on the advances, challenges, and emerging scenarios in Workers’ Health (WH), based on its publications. Articles published between 1998 and 2024 were analyzed using data from SciELO and C&SC archives. In this period, 292 articles on WH were published, of which 171 were empirical studies focused on specific occupational groups, with particular emphasis on industrial workers (14%), healthcare workers (12.9%), and rural workers (9.9%). The publications featured diverse theoretical and methodological approaches, with a predominance of qualitative studies (35.9%), epidemiological studies 32.7%), and studies on WH policies (17.1%). A lack of research on emerging topics such as remote work and algorithmic management was noted, along with the invisibility of groups such as quilombolas, Indigenous peoples, domestic workers, and LGBTQIA+ workers. These gaps highlight ethnic-racial, gender, and epistemological inequalities, reflected in the underrepresentation of specific topics and groups. The analysis reaffirms C&SC’s role in promoting the value of Workers’ Health and fostering inclusive and transformative knowledge.

Key words:
Workers’ Health; Scientific Production; Health Policies; Health Inequalities

Resumo

A Revista Ciência & Saúde Coletiva (C&SC) consolidou-se como espaço de excelência na difusão do conhecimento científico em Saúde e Trabalho. No marco dos 30 anos da revista, este artigo apresenta uma reflexão crítica sobre os avanços, desafios e novos cenários para a Saúde do Trabalhador/a (ST), a partir de suas publicações. Foram analisados artigos entre 1998 e 2024, com base em dados do SciELO e dos arquivos da C&SC. No período analisado, foram publicados 292 artigos em ST, dos quais 171 consistem em estudos empíricos voltados a categorias ocupacionais específicas, com destaque para trabalhadores da indústria (14%), dos serviços de saúde (12,9%) e trabalhadores ru rais (9,9%). As publicações apresentam abordagens teórico-metodológicas diversas, com predomínio de estudos qualitativos (35,9%), epidemiológicos (32,7%) e em políticas de ST (17,1%). Observou-se ausência de estudos sobre temas recentes como trabalho remoto e gestão algorítmica, além da invisibilidade de grupos como quilombolas, povos originários, trabalhadores domésticos e LGBTQIA+. Tais lacunas evidenciam desigualdades étnico-raciais, de gênero e epistemológicas, refletidas na sub-representação de temas e grupos. A análise reafirma o papel da C&SC na valorização da ST e na promoção de conhecimento inclusivo e transformador.

Palavras-chave:
Saúde do Trabalhador; Produção Científica; Políticas de Saúde; Desigualdades em Saúde

Resumen

La Revista Ciência & Saúde Coletiva (C&SC) se ha consolidado como un espacio de excelencia para la difusión del conocimiento científico en Salud y Trabajo. En el marco del 30º aniversario de la revista, este artículo presenta una reflexión crítica sobre los avances, desafíos y nuevos escenarios para la Salud de los Trabajadores (ST), a partir de sus publicaciones. Se analizaron artículos de 1998 a 2024, con base en datos de SciELO y del archivo de C&SC. Durante el período analizado, se publicaron 292 artículos sobre ST, de los cuales 171 consistieron en estudios empíricos centrados en categorías ocupacionales específicas, con foco en trabajadores industriales (14%), servicios de salud (12,9%) y trabajadores rurales (9,9%). Las publicaciones presentaron diversos enfoques teóricos y metodológicos, con predominio de estudios cualitativos (35,9%), estudios epidemiológicos (32,7%) y estudios de políticas de ST (17,1%). Se observó una falta de estudios sobre temas recientes como el teletrabajo y la gestión algorítmica, así como la invisibilidad de grupos como quilombolas, pueblos indígenas, trabajadoras del hogar y personas LGBTQIA+. Estas brechas ponen de relieve las desigualdades etnoraciales, de género y epistemológicas, que se reflejan en la escasa representación de temas y grupos. El análisis reafirma el papel de la C&SC en la valoración de la salud laboral y la promoción del conocimiento inclusivo y transformador, con el potencial de fortalecer las políticas públicas y garantizar la equidad en la salud de los trabajadores.

Palabras clave:
Salud de los trabajadores; Producción científica; Políticas de salud; Desigualdades en salud

Introduction

In 1986, during Brazil’s democratic transition, social movements, unions, and civil society organizations expanded their participation in public policymaking. Two events stood out in this context: the Eighth National Health Conference, which consolidated the principles of the Health Reform Movement and defended health as a universal right, and the First National Conference on Workers’ Health, which incorporated working conditions as determinants of the health-disease process. In 1988, the Federal Constitution recognized health as a right of all, a duty of the State, and a right of all citizens. Two years later, in 1990, the Unified Health System (SUS) was created, consolidating these advances and establishing a public, universal, and participatory model based on the principles of universality, comprehensiveness, equity, and social control.

In this context, in 1996, the Brazilian Collective Health Association (Abrasco) created the Journal Ciência & Saúde Coletiva (C&SC) as a “scientific space for discussions, debates, presentation of research, and the exposition of new ideas and controversies in the field”¹. In the scientific field, the Journal strengthened critical and interdisciplinary production in Collective Health, promoting dialogue between academia, health services, and social movements.

In 2026, the journal will celebrate its thirtieth anniversary, having become one of the leading scientific references in Collective Health in Brazil and Latin America. Throughout its history, the Journal was fundamental to disseminating critical, proactive, innovative, and interdisciplinary knowledge, opening up space for the most diverse approaches and thematic areas that comprise health today. Among C&SC’s important editorial areas are Workers’ Health and Environmental Health, which have played a significant role in shaping this history.

In 1977, in Italy, workers and union health advisors, under the leadership of Ivar Oddone, developed innovative strategies for fighting for health that gave rise to the Italian Workers’ Model (MOI)². This model had a significant impact in Brazil, influencing the debate on health and work, strengthening the union movement, and contributing to the The Brazilian Health Reform movement^3,4. The MOI’s experiences engaged with local demands and stimulated institutional proposals coordinated with the labor movement, culminating in the First National Conference on Workers’ Health (WH). This process consolidated the concept of WH as a broader, interdisciplinary approach, transcending the limits of traditional Occupational Health^5,6. Thus, it fostered an interdisciplinary understanding of illness and care, articulating social sciences and the public health tradition in protecting health and the workplace⁷.

This social and institutional action consolidated WH as a component of the public health system when it was formally incorporated into the 1988 Federal Constitution. Section II of article 200 assigns to the State the responsibility of “conducting health and epidemiological surveillance actions, as well as workers’ health actions”⁸. We underscore the pioneering nature of the Brazilian Unified Health System (SUS), incorporating WH as a structuring policy almost two decades before international recognition. It was only in 2007, during the Sixtieth World Health Assembly, that the World Health Organization (WHO) officially adopted the concept of Workers’ Health, replacing the term Occupational Health, with the launch of the Global Action Plan on Workers’ Health. In this document, the WHO recommended that all public health services worldwide incorporate actions in this field⁹.

The institutionalization of Workers’ Health has brought significant advances, such as the creation of the National Network for Comprehensive Workers’ Health Care (RENASTT) in 2002, which reached 215 referral centers by 2022¹⁰. In 2012, the National Workers’ Health Policy (PNSTT) defined principles, guidelines, and strategies for promoting and protecting health and reducing morbidity and mortality related to production processes. Based on universality, the PNSTT covers the entire Economically Employed Population (EEP) - approximately 104 million people in 2021¹¹. This poses significant challenges to SUS sectoral policies, given the scale and complexity of the actions involved.

Despite institutional advances in consolidating WH as a public policy, a parallel process of intensifying precariousness is observed, driven by the loss of social and labor protections. These changes stem from the convergence of technological disruptions and neoliberal policies that restrict or even eliminate social rights, generating processes of precarious work, impacting the deterioration of working conditions, and the lack of protection for workers’ health. This scenario is a backdrop of Fordism in crisis, coupled with the spread of new technologies, such as information and communication technologies (ICTs), which have fueled precarious employment characterized by subordination to algorithmic management models. The ICTs are Artificial Intelligence techniques that simulate human skills, especially the cognitive managerial activities associated with management, programmed to reproduce an intensified rationality of Taylorist work organization principles, with harmful impacts on subjectivity and working conditions. In these social labor relations, conventionally referred to as “work uberization”, companies fail to assume labor responsibility and promote the extreme subjugation of workers as a kind of modern-day servitude¹². Ideologically, large technology companies (“big-tech”) have been promoting a discourse that displaces the identity of their millions of workers into the unrealistic figure of “entrepreneurs”¹³, or self-entrepreneurs¹⁴. This symbolic framing hinders the recognition of labor relations and weakens union organizing and the formulation of public Workers’ Health policies aimed at this emerging sector.

In this sense, there is a significant increase in unprotected worker groups lacking health promotion, prevention, and assistance. This fact exacerbate contradictions that change life and labor relations in society and reveals troubling settings that drastically compromise working and health conditions^14,15, perpetuating and coexisting with cruel exploitation forms, such as child labor and contemporary slave labor.

Another significant and extremely challenging event for the WH during this period was the spread and onset of the most significant health crisis in the last 100 years, the COVID-19 pandemic. The pandemic started in 2020 and lasted approximately three years. It was classified as an international health emergency by the WHO and affected more than 39 million people and was responsible for 716,238 deaths¹⁶ in Brazil.

This situation was severely aggravated by the denialist policy, managed and planned by the militarized group that took over the Ministry of Health between 2019 and 2022. During this critical period, the pandemic severely affected workers, especially health workers and informal workers, who were vulnerable and precarious. It also reshaped several work processes, resulting in the unprecedented adoption of remote work. This practice escalated during the COVID-19 pandemic and was subsequently permanently incorporated into the routines of millions of workers. This reconfiguration contributed to blurred boundaries between the home and the professional environment¹⁷, establishing new paradigms in work relationships and requiring both technological and subjective adaptations.

Combined with labor exploitation, processes driven by capitalist interests are advancing, degrading nature and exacerbating the environmental crisis, evidenced by global warming and the destruction of planetary biodiversity. The environmental crisis, given its unprecedented magnitude, is leading to predicted colossal and even apocalyptic catastrophes that threaten the future of humanity. This reality imposes a new paradigm for research, also associated with Workers’ Health, which must focus on understanding the direct impacts on work processes and developing strategies to mitigate the effects of worst-case environmental outlooks on health and working conditions.

On the other hand, the advancement of social policies focused on workers’ health has stressed the need to incorporate historically invisible dimensions related to categories of workers subjected to conditions of structural precariousness. These include practices within traditional communities, such as family farmers, Indigenous peoples, the remnants of quilombolas, and extractive workers, whose specificities demand intersectional and territorialized approaches.

In this context, studies that rediscover the history of Brazilian workers and the founding violence of the colonial period, marked by approximately four centuries of enslavement of Black people in the Americas, emerge. This slavery legacy remains one of the structuring determinants of the world of work in the country, perpetuating forms of racialization, inequality, and exclusion. Racism - in its structural, systemic, behavioral, institutional, cultural, environmental, recreational, and epistemic dimensions - is a social determinant of health that imposes greater exposure to risk and vulnerability on the Black population. This fact translates into perverse indicators, such as the higher prevalence of work-related accidents and illnesses among Black workers, as well as the multiple forms of physical and psychological violence to which they are subjected¹⁸.

The aspects discussed above highlight key points for the health and work field in Brazil throughout its history. This historical trajectory intertwines with the 30 years of C&SC. By consistently including the editorial section of “Health and Work”, the Journal has been present throughout this history, contributing significantly to the dissemination of scientific production related to the central themes of workers’ health. The trajectory outlined by the articles published between 1998 and 2024 shows an extremely vigorous scientific production. These articles address the contextualization of Workers’ Health, explore diverse theoretical approaches and methodological strategies stemming from multiple disciplinary fields, analyze the policies implemented in the Unified Health System (SUS) and other intersectoral spheres that articulate with WH, and offer critical reflections and identify challenges faced in this turbulent historical context.

Contemporary challenges are several and interdependent, requiring a thorough understanding of their multiple dimensions and impacts on work and health processes. In this context, the importance of solid, critical, and interdisciplinary scientific research is highlighted, capable of supporting qualified response actions in WH. C&SC has played a relevant role in this process, by disseminating knowledge that articulates different disciplinary fields and theoretical-methodological perspectives, contributing to the advancement of public policies and the strengthening of health practices¹⁹.

Thus, C&SC is primarily a space for disseminating scientific knowledge and the state of the art, based on rigorous scientific criteria that ensure the technical and scientific quality of the published articles. Consequently, one should understand the significant existing production, which includes theoretical concepts and models, working conditions and their transformations, production processes, training and related pedagogical strategies, and situations and changes in the epidemiological profile of health problems, reflected in the Journal’s robust database of publications.

This article aims to analyze the scientific production on Workers’ Health published between 1998 and 2024 in the journal Ciência & Saúde Coletiva. Based on this analysis, we propose a critical reflection on the advances, challenges, and new settings emerging for WH in Brazil.

Methods

To systematize information on the scientific output published in C&SC, a database was created using information provided by the Journal’s Secretariat. Initially, we were provided with a spreadsheet listing all articles published during the study period. Based on this list, we consulted the SciELO database. SciELO (Scientific Electronic Library Online) is an electronic library that gathers scientific journals from several countries, particularly Latin America, the Caribbean, and Spain. C&SC was included in the SciELO collection in 2002, but offers access to articles published since its inception (1996).

The following information was extracted from SciELO: title, keywords, year, first author’s institution, first author’s state, abstract, and link to the full article. This information was stored in Excel spreadsheets.

Subsequently, the abstracts were read, and the articles were classified according to: (i) approaches to Workers’ Health (Epidemiology; Social Sciences; Policies, Management and Evaluation; Theoretical, Conceptual and Methodological Aspects; Literature Reviews; and Environmental Health/Toxicology; (ii) methodological strategies employed; and (iii) main themes or focus groups. The full versions of the articles were consulted to support this classification.

The classification adopted to organize the articles according to their focuses - Epidemiology, Social Sciences in Health, Policy, Management, and Evaluation - was motivated by the need to encompass the main dimensions that constitute the field of Workers’ Health/Collective Health. Three significant areas of knowledge production are recognized within Collective Health. This structuring allowed for a coherent mapping of scientific production, valuing the WH’s interdisciplinarity and complexity. We also chose to specify environmental health and toxicology studies, as these are inaugural studies in the field and use specific measurement methods that are not always fully aligned with the epidemiological method. Additionally, studies in Environmental Health and Toxicology were specified as a distinct category, as they represent foundational contributions to the field and employ specific measurement methods that are not always fully aligned with the epidemiological approach. The category of Theoretical, Conceptual, and Methodological Aspects further highlights the importance of critical reflection and epistemological development, which are fundamental to improving research and intervention practices. Thus, the classification adopted sought to reflect the diversity and integration of knowledge and practices in Collective Health applied to WH.

We defined two major groups to classify the methodologies: empirically based research and articles with theoretical-conceptual-methodological reflections. This distinction allowed us to identify studies based on field data collection and analysis and those focusing on theoretical, methodological, and critical aspects of the field and the systematization of the knowledge produced. Field-specific approaches were highlighted to give these contributions visibility.

When describing the production by geographic area and institution of affiliation, we used the information related to the first author as a reference.

Articles resulting from thematic calls for papers were excluded, as they involved thematic induction, which could compromise the heterogeneity of the data analyzed: “Workers’ Health in Times of Social and Environmental Change” (2019), “Contemporary Challenges in Workers’ Health” (2021), and “Working Conditions and Mental Health of Healthcare Workers in the Context of COVID-19 in Brazil” (2022).

The data were systematized into graphs and tables. The analysis used SPSS, version 24.0.

Results and discussion

General characteristics of output

The inaugural article in the Health and Work thematic area was published in 1998. A total of 292 articles were published from 1998 to 2024. The output analysis reveals fluctuations in specific periods, with a higher concentration of articles from 2010 to 2013 (Graph 1). After a significant drop between 2015 and 2017, which interrupted the previous growth trend, a renewed increase has been observed from 2018 onward.

Graph 1
Distribution of the number of articles per year in the 1998-2024 period. Journal Ciência & Saúde Coletiva, 2025.

The place of publication was classified based on the first author’s affiliation, which was employed to identify the region, state, and responsible institution. The Southeast accounted for 53.1% of publications, followed by the Northeast (24.3%). There were no publications from the North. Rio de Janeiro (24%), São Paulo (16.1%), and Bahia (12%) had the highest percentage of publications among Brazilian states (Table 1).

Table 1
Distribution of articles published in the Journal Ciência & Saúde Coletiva by geographic area. Brazil, 2025.

Region*/State		n	%
Region
Southeast		155	53.1
Northeast		71	24.3
South		41	14.0
Midwest		17	5.8
Other country		8	2.7
States
	Rio de Janeiro	70	24.0
	São Paulo	47	16.1
	Bahia	35	12.0
	Minas Gerais	31	10.6
	Rio Grande do Sul	23	7.9
	Ceará	14	4.8
	Santa Catarina	13	4.5
	Pernambuco	10	3.4
	Federal District	8	2.7
	Rio Grande do Norte	7	2.4
	Espírito Santo	6	2.1
	Paraná	5	1.7
	Mato Grosso	4	1.4
	Goiás	4	1.4
	Paraíba	3	1.0
	Maranhão	1	.3
	Piauí	1	.3
	Mato Grosso do Sul	1	.3
	Sergipe	1	.3
	Other country	8	2.7
Total		292	100.0

• Note: Only the first author was considered in the classification. *No production was identified in the North region.
• Source: Authors.

Regarding the institutions responsible for the scientific production, Fiocruz/RJ (16.1%), UFBA (7.9%), and USP (6.2%) stood out (Table 2). We identified more than one hundred institutions. This institutional diversity highlights the scope of C&SC as an essential platform for collaborative scientific production and the strengthening of Workers’ Health in Brazil.

Table 2
Distribution of articles published in the Journal Ciência & Saúde Coletiva by first author’s institution. Brazil, 2025.

Institution		n	%
Oswaldo Cruz Foundation - Rio de Janeiro		47	16.1
Federal University of Bahia		23	7.9
University of São Paulo		18	6.2
State University of Campinas		12	4.1
Federal University of Minas Gerais		11	3.8
Federal University of Santa Catarina		6	2.1
Federal University of Ceará		6	2.1
Federal University of Espírito Santo		6	2.1
Federal University of Pelotas		6	2.1
Federal University of Rio Grande do Sul		6	2.1
University of Brasília		5	1.7
Federal University of Rio de Janeiro		5	1.7
Minas Gerais State Secretariat		5	1.7
Federal University of Mato Grosso		4	1.4
Southwest State University - BA		4	1.4
State University of Feira de Santana		4	1.4
Federal University of São Paulo		4	1.4
Oswaldo Cruz Foundation - Pernambuco		4	1.4
State University of Londrina		4	1.4
Fluminense Federal University		3	1.0
Federal University of São Carlos		3	1.0
Federal University of Rio Grande do Norte		3	1.0
State University of Rio de Janeiro		3	1.0
Oswaldo Cruz Foundation - Ceará		3	1.0
University of the Extreme South of Santa Catarina		3	1.0
State University of Montes Claros		3	1.0
Fortaleza Municipal Secretariat		3	1.0
Total number of articles in institutions with two publications1		30	10.3
Total number of articles in institutions with one publication2		58	19.6
Total		292	100.0
Institution type
	Universities/Research Centers/Federal Institutes	256	87.7
	SUS Health Services3	27	9.2
	Other Governmental/Non-Governmental Agencies4	9	3.1
	Total	292	100.0

• Notes: ¹ Institutions with two published articles: Army Officer Training School, Marília School of Medicine, FUNDACENTRO, IBGE, INCA, SES-SP, UECE, UFG, FURG, UNESP, UERN, PUC-RS, UNIC, and ULBRA. ² Institutions with one published article: SES-RJ, SES-RN, SES-BA, SES-MG, SES-GO, SMS-Bento Gonçalves, SMS-Quissamã, SMS-RN, ESF Unit, CAPS, Ministry of Health, Sarah Kubitschek Hospital, IPEA, Petrobrás, IMIP, Civil Police-RJ, INSS, FGV-SP, UFJF, UFSM, UFMA, UFPI, UFPB, UFSJ, UFS, UFU, Fiocruz-MG, Unipampa, UFPE, IFSP, IFNMG, IFF, UNIFOR, EBSP-BA, PUC-Pelotas, PUC-Campinas, University of the South of Santa Catarina, University Tuiuti-PR, Presidente Antônio University, Gama Filho University, Salgado Filho University, UNINASSAU, UNISC, Chapecó University, Santa Catarina Coastal University, São Leopoldo University, Barão de Mauá University Center, João Pessoa University Center, ABC University Center, London College, National Autonomous University of Mexico, Tondela-Viseu Hospital, Minho University, UMASS, University College London, University of Zaragoza, and University of Monterrey (Mexico). ³ Fundacentro, IPEA, IBGE, INSS, and Petrobrás. ⁴ Municipal and state health secretariats, primary care units (health centers and Family Health Strategy units), Psychosocial Care Center and Ministry of Health.
• Source: Authors.

Universities and research centers accounted for 87.7% of publications. Despite the extensive network of CERESTs in the country, health services contributed only 9.2%, highlighting a significant gap in reflection and knowledge production regarding the actions of these services.

Regarding the focus, we underscore the inputs of epidemiological studies (36.2%) and social sciences (34.8%), highlighting the coexistence of different research paradigms in the field. Policies, Management, and Evaluation in WH represented 14.5% of the output, while theoretical/conceptual/methodological approaches corresponded to 6.2% (Table 3). Considering the methodologies adopted, qualitative methods prevailed in approximately 30% of the articles, and essays represented 22.1% of the articles. Cross-sectional studies (16.3%) and surveys (13.1%) were the most commonly used among epidemiological studies, with a lower presence of cohort studies (1.4%). Other methodological approaches included literature reviews (8.3%), mixed methods (2.4%), and research instrument validation studies (2.1%). In the field of environmental health, 1.7% of the studies involved biological and environmental monitoring and spatial analysis (1.1%) stood out. Psychosocial and ergonomic approaches, such as work psychodynamics (1.0%) and Ergonomic Work Analysis (EWA) (0.7%), were also identified, albeit in isolated instances. This distribution reveals diverse research approaches and strategies, reflecting the complex objects of study in Workers’ Health.

Table 3
Main approaches and methodologies used in scientific production in Health and Work published in Journal Ciência & Saúde Coletiva, 1998-2024.

		n	%
Main approaches
Epidemiology		105	36.2
	Environmental Health/Toxicology	8	2,8
Social Sciences in Health		101	34.8
Policy, Management, and Evaluation in Workers’ Health		42	14.5
Theoretical, Conceptual, and Methodological Aspects		18	6.2
Literature Review		16	5.5
Total		2901	100.0
Methodologies used
Empirical-based research
	Qualitative methods2	84	29,1
Epidemiological studies3
	Cross-sectional	47	16,3
	Survey	38	13,1
	Cohort	4	1,4
	Time series	2	0,7
	Information System	1	0,3
Environmental health
	Biological/toxicology monitoring	5	1,7
	Spatial analysis	3	1,1
Workers’ Health specific approaches
	Psychodynamics of Work	3	1,1
	Ergonomic Work Analysis (EWA)	2	0,7
Mixed methods (qualitative-quantitative approach)		7	2.4
Research instrument validation studies		6	2.1
Articles on theoretical, conceptual and methodological reflections
Essay		63	21.7
Literature review		24	8.3
Total		2894	100.0

• Notes: ¹ Two editorial articles were excluded. ² Qualitative methods include: semi-structured interviews, focus groups, observation, ethnographic studies, case studies, and document analysis. ³ Surveys were defined as studies that aimed to describe the presence of an exposure or a health outcome. Cross-sectional studies were studies that analyzed the association between a health outcome and its determinants (exploratory or analytical studies). ⁴ Editorials (n=2) and one debate article (n=1) were excluded.
• Source: Authors.

Empirical studies: production focusing on specific work contexts

Based on a reading of the abstracts of the 292 published articles, those with information on the categories of workers investigated (research subjects) were selected. A total of 171 publications (58.5% - more than half of the total) were identified, focusing on empirical studies on working conditions and health in occupational groups, indicating a predominance of studies focused on the concrete reality experienced by workers and its impacts on health. Furthermore, the analysis highlighted relevant aspects of the evolution of research over the last 30 years.

Among the specific categories or those grouped by sector, industrial workers stood out, with 24 publications (14% of the total) (Table 4). The first publications focusing on this category emerged in the late 1990s and escalated from 2000 to 2020. However, we noted the lack of publications on this group in the current decade, indicating a possible research continuity gap.

Table 4
Distribution of categories of workers grouped into sectors or specified in research objects by publication year.

Categories of workers (specific and grouped)	Publication year (number of articles)	n	%
Workers in general industry/metallurgy; meatpacking; lumber; oil and plastics; construction; ceramics; batteries.	1998 (2); 2003; 2005; 2008 (2); 2009; 2009 (6); 2010 (4); 2013 (7); 2018	24	14.1
Health Sector - Workers without category specification who work in Family Health teams	2002; 2005 (2); 2007; 2009 (2); 2010 (4); 2011 (5); 2013 (3); 2018 (2); 2024 (2)	22	12.9
Health Sector - Workers in the public health sector in general - hospitals and other health institutions.	2001; 2005; 2008; 2010 (2); 2011 (3); 2012; 2013 (4); 2018; 2019 (2); 2023	17	9.9
Rural populations/rural workers, settlers, and migrants	2010; 2011; 2012 (2); 2013 (3); 2017; 2018 (3); 2019 (4); 2024 (2)	17	9.9
Municipal, state, and university professors	2004; 2006; 2009; 2012 (2); 2013 (4); 2018; 2019 (2); 2022; 2023 (2)	15	8.8
Recycling workers - waste pickers and urban cleaners	1998; 2005; 2009; 2011 (2); 2013 (2); 2019 (2)	9	5.4
Health workers in public hospitals	1999; 2005; 2010; 2011; 2012 (2); 2018; 2024	8	4.8
Nursing workers - public sector	2007 (3); 2011; 2012; 2013; 2024 (2)	8	4.8
Family Health Strategy dentists; oral health professionals	2006 (2); 2013 (3); 2024 (2)	7	4.1
Police and military personnel in general	2005; 2009; 2010; 2011; 2019 (2); 2024	7	4.1
Community Health Workers	2008 (2); 2010; 2011; 2012; 2013	6	3.5
Small-scale fishermen/shellfish gatherers	2010; 2011; 2015; 2019 (2)	5	3.0
UFS doctors	2008; 2009; 2010; 2011 (2)	5	3.0
Family Health Strategy managers	2010; 2020 (2); 2023	4	2.3
Physiotherapists; Nutritionists	2007; 2011; 2018; 2022	4	2.3
University staff	2012; 2013 (2)	3	1.7
Drivers in general	2009 (2); 2023	3	1.7
CAPS professionals	2005; 2009	2	1.2
Pharmacy workers	2010; 2011	2	1.2
Motorcycle couriers	2005	1	0.1
Others - Students	2012; 2013	2	1.2
Total		171	100.0

• Note: Articles involving specific occupational groups accounted for 53.8% of the total (171 of 324). Healthcare workers stood out, with 50.3% of the articles published (n=86).
• Source: Authors.

Studies conducted with categories working in Primary Health Care (PHC) ranked second, with 22 articles (12.9%). Also noteworthy are studies on rural workers, with 17 articles, representing 9.9% of the total.

The set of categories investigated in the health sector - PHC Units/UBS, Family Health Strategy/ESF, health in general, Psychosocial Care Centers (CAPS), and specific categories such as community health workers, doctors, dentists, UBS/ESF managers, physiotherapists, nutritionists and pharmacists - totaled 86 publications (50.3%), evidencing significant production of studies in this sector.

The categories and economic sectors cited in Table 4 reveal significant and diverse scientific output in the field of WH and allow for developing hypothetical approximations regarding the areas of greatest interest and existing research gaps, given the significant volume of publications. From this perspective, we opted to focus on analytical aspects. Categorizing occupations, the result of the intense division of labor and the changing nature of work²⁰, is a challenging task, considering that, in Brazil, the Brazilian Classification of Occupations (CBO) describes 2,741 occupations in its last update (2023). Thus, the data presented in Table 4 reflect the categories primarily studied by the research centers that published in the journal and not the country’s occupational profile.

The development of the WH field in Brazil was strongly influenced by the Italian Workers’ Movement (MOI)². From the 1980s onwards, the MOI’s experience spread among metalworkers in the ABC region of São Paulo and surrounding areas²¹, and, in conjunction with the strengthening of the trade union movement, led to the creation of technical union advisory services and research units, as well as the establishment of the Interunion Department for Workers’ Health, modeled after the Interunion Department of Statistics and Socioeconomic Studies (DIEESE). In this historical phase, as reflected in the data in Table 4, the fight for health was incorporated into the unions, expanding the focus that had previously been restricted to economic demands, which was fundamental to establishing WH in Brazil. This dynamic, combined with the health reform movement, led to the holding of the First National Conference on Workers’ Health (1986) and the emergence of pioneering experiences in the field, especially in the industrial zones of Cubatão and the ABC region of São Paulo³.

Research in these industrial categories became an object in the field of WH during a period of affirmation of Fordism in the Southeast of the country, where a strong union movement was also concentrated, with significant demands for improvements in working and health conditions⁴. This background influenced the production of research focused primarily on the industrial sector, with more significant results in the 2010s and a persistent reduction until the lack of records in the 2020s. This decline may be related to the Fordist model’s crisis, the tertiarization of economies in developed and emerging countries, the declining strength of unionism²⁰, and the decrease in industrial jobs.

Subsequent circumstances have deteriorated this outlook with exacerbated precarious employment relations and rising unemployment, driven by the neoliberal logic of fragmenting labor and social achievements, ongoing since the second half of the 20^th century¹³. These conditions and determinants have changed the epidemiological profile of WH, with the sharp rise in work-related mental disorders standing out among the leading indicators of this change^22,23. This transformation has been reflected in the significant presence of mental health issues among C&SC publications in recent years.

Despite the evident consequences of worker health issues, extensively documented and analyzed by scientific literature in recent decades, there has been a parallel shift in the focus of union agendas. The struggle for better working conditions and health has lost its centrality in the face of more urgent economic demands, such as combating wage losses, job insecurity, and unemployment. This shift may, in part, explain the recent decline in the publication of articles addressing these issues.

Another notable aspect of the evolution of publication results highlights the strong predominance of tertiary sector categories from the first decade of the 21^st century onward, as seen in Tables 1 and 4. Thus, the set of categories, individually or grouped in Table 4, shows that 70.3% of the articles refer to the tertiary sector. The so-called society tertiarization indicates that the economies, and consequently the work, of developed and emerging countries are increasingly based on economic activities in the service sector²⁴. At the beginning of this century, the tertiary sector, also known as the services sector, accounted for more than two-thirds of GDP in developed countries and Brazil, employing approximately three-quarters of the economically active population^25,26. According to Freyssinet²⁷, services became the leading job creator from the end of the last century onward, showing a diversified, gigantic scale associated with the several primary and secondary sectors of the economy. This figure represents 62.7% of employment in the tertiary sector in 2018²⁶ and across economic activities, which is close to the 70.3% proportion found in the articles analyzed.

However, across all service sector categories, studies focused predominantly on public health activities in general, accounting for 50.3% of publications. This situation does not reflect the reality of the tertiary sector, as discussed previously. The predominance of studies in public health sector categories, particularly in PHC, can be explained by factors such as easy access and institutional ties between public sector professionals and research centers working in the field of WH in Brazil. Furthermore, contributing factors include growing WH training initiatives, especially in the service sector, the creation of RENAST in 2005, and the extensive expansion of CERESTs²⁸.

The training of researchers from CERESTs likely strengthened the concentration of studies in the public sector, especially in Health, due to easy access and institutional integration. This bias is also evident in the significant number of research projects conducted at public universities and schools. As a result, academic production reflects a biased view of the tertiary sector, conditioned more by the accessibility of the contexts investigated than by the representativeness of the occupational reality in the country. The difficulties in accessing Brazilian private companies and institutions are another factor that explains this concentration on public services.

In the private sector, it is well known that many companies impose obstacles or restrictions on researchers interested in conducting studies in their workplaces, which prevents them from uncovering substandard working conditions and high rates of health problems among workers. Furthermore, the significant loss of labor rights, which began with the Fordism crisis and deteriorated in the 21^st century, has generated a variety of work types - outsourced, temporary, fixed-term, intermittent, rural partnerships, para-subordinate, self-employed, and assigned to legal entities (recruiting employees through false legal entities)^12,29. This diversity hinders reporting and access to data for research in institutional databases or directly with workers. Thus, barriers to data production and access to existing databases limit the scope and diversity of occupational categories investigated in this sector.

Final considerations

Identified gaps and development prospects

Within the thematic scope of the categories analyzed, we observe a lack of studies on recent events related to technological advancement, such as remote work and algorithmic management on digital platforms. This gap highlights the difficulty of scientific output in keeping pace with the rapid transformations in work organization, especially outside of formal employment relationships. The emergence of new labor configurations, often marked by statistical invisibility and fragmented rights, challenges the established frameworks of WH and highlights the need for methodological and political updates in the field.

Clearly, this technological disruption is a recent event that has escalated over the last ten years and is manifested, above all, through the so-called work uberization¹². This process has brought about profound changes in labor relations, exacerbating precariousness, fragmenting employment relationships, and weakening social protection mechanisms, as well as access to workers’ health protection services. As a result, workers face greater difficulties in accessing health services and institutional protection and surveillance instruments, which increases their invisibility in the field of Workers’ Health. Furthermore, the advancement of computerization and the predominance of management algorithms, especially in companies based on digital platforms, make it impossible for workers to gain access to information, not only for research purposes but also for oversight and control institutions, such as the Ministry of Labor’s Labor Inspectorate, the Public Prosecutor’s Office of Labor, and the CERESTs (Workers’ Associations), and the workers’ unions themselves, when unions are established. Platform companies thus impose a perverse paradigm of misinformation and data concealment, hindering the visibility and protection of these workers, further exacerbating vulnerabilities in WH.

The emblematic example is that of UBER workers, whose exact number is unknown and estimated in disparate figures, ranging from 1.5 to 5 million, with an average of approximately 3 million. This category makes Brazil the country with the largest contingent of platform-based drivers in the world. There is no public access to the records of these workers, which are kept under corporate secrecy, making them impenetrable and beyond the sovereign control of Brazilian public institutions. The extreme precariousness, typical of this phase known as “work uberization”, incorporates this component of workers’ concealment from the systems regulating labor relations and conditions - something unprecedented in history since the Industrial Revolution. Regarding research, this situation primarily hinders epidemiological studies. However, it does not prevent the application of quantitative and qualitative methodologies to these categories, which are likely to increase in the coming years. Research centers are likely paying close attention to these transformations, and articles addressing this issue are expected to be published in the coming years.

Table 4 data show the growth of studies that expand the scope of WH to a broader group of categories, beyond industrial workers and the formal tertiary sector. WH is part of Collective Health and started its institutionalization process with the 1988 Federal Constitution, notably Article 200, followed by Law N° 8.080, which guarantees health as a right and duty of the State, as a universal principle. This fact leads to the expanded universe of sectoral action of WH beyond formal employment relations, also explained in the National Workers’ Health Policy enacted in 2012. With this, WH actions reach the entire economically active population and no longer just the formal labor market.

Within the scope of this broad policy, we observed publications that addressed various segments of rural workers, including settlers and small farmers, small-scale fishermen, and categories of recyclable urban waste and cleaning workers, which, together, corresponded to 18.2% of the publications, as described in Table 4. These studies elucidate health realities and problems in categories that do not have access to WH services because they are traditionally outside the formal market, and the production of research has reflected this situation with a considerable number of articles that address these invisible categories.

Despite this, the results of this review indicate the need to expand publications focused on categories that are invisible and discriminated against by society, revealing gaps in existing knowledge. The data analyzed highlight the lack of studies on remaining quilombola populations, Indigenous peoples, and significant categories in our reality, such as domestic workers, with approximately 6 million employees, most of whom are Black³⁰, among others.

These gaps reveal epistemological, ethnoracial, and gender discrimination, highlighting the urgent need for research centers to overcome this situation. It is crucial to invest in thematic areas related to racism, unequal gender relations in the worlds of work and health, intersectionality, LGBTQIA+ workers, and other historically marginalized groups. Only then will it be possible to build inclusive and transformative knowledge to promote social justice and equity for all workers.

The analysis of articles published from 1998 to 2024, including thematic approaches, methods, and groups investigated, highlighted the diverse and rich knowledge disseminated, promoting interdisciplinarity in WH. The results guide surveillance actions, public policies, and workplace interventions, besides supporting the critical training of professionals and strengthening scientific output in the field.

Over the past 30 years, the Journal has played a significant role in addressing the WH challenges, significantly expanding knowledge, raising the profile of the most vulnerable groups, and strengthening public policies in the field. With its ongoing commitment to quality and thematic diversity, it will undoubtedly continue to be an essential platform for scientific production and critical debate, monitoring, and driving the transformations needed to protect and promote the health of the working population.

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• Chief editors:
  Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva, Vania de Matos Fonseca

Publication Dates

• Publication in this collection
  06 Oct 2025
• Date of issue
  Sept 2025

History

• Received
  26 July 2025
• Accepted
  28 July 2025
• Published
  30 July 2025